OBJECTIVES:

For law middle income country like Egypt characterized with high prevalence of hypertension in (26%) which an important driver of adverse cardiovascular outcomes (19%) acute coronary syndromes (ACS) could be considered be as an economic burden on health system.

The objective for this study is evaluating introducing Ticagrelor to national formulary and its impact on outcomes for (ACS) patients for better resource management.

METHODS:

The study adopted a two-part cost-utility model comprising a short-term decision tree and a long-term Markov structure was utilized to estimate long-term costs and health outcomes. The aim of the modeling exercise was to adhere closely to the PLATO study and the model structure is based on the key clinical outcomes of PLATO. Data from PLATO were used to estimate rates of cardiovascular events, health-care costs, and health-related quality of life for the 12 months of therapy

Event Risk, Quality of life were from PLATO

To test the robustness of our results to variation in the estimates of the input model parameters, we performed various one-dimensional sensitivity analyses

Time horizon was 12 months

Results obtained in form of QALY.

RESULTS:

During the life-time horizon, total costs, QALY gained for Ticagrelor plus ASA was (9.5 QALY) versus (9.3) QALY for Clopidogrel plus ASA. This leads treatment with Ticagrelor is associated with highest effectiveness and accepted costs Ticagrelor was the preferred option in 90% of simulations at Egyptian national formulary

CONCLUSIONS:

Ticagrelor was the most cost-effective agent when used as part of dual antiplatelet therapy this will support introducing Ticagrelor to national formulary and treatment guidelines to enhance (ACS) outcomes and better resource utilization